Health care income verification a symbolic gesture

Oct. 18, 2013

Written by

Kelly Kennedy

USA TODAY

WASHINGTON — As part of the deal that ended the government shutdown, House Republicans gained one Affordable Care Act concession.

But even Republicans acknowledge it's not much of a coup.

"Its symbolic importance is clear, I don't think there's any question about that," said Douglas Holtz-Eakin, former director of the Congressional Budget Office and former chief economic policy adviser to the 2008 presidential campaign of Sen. John McCain, R-Ariz.

But the rule itself "leaves a lot of latitude" for Health and Human Services Secretary Kathleen Sebelius.

"That means we're effectively where we are now," Holtz-Eakin said.

The agreement signed Thursday by President Obama says HHS will give Congress two reports:

• A report showing how the government plans to ensure that people who sign up for the health insurance exchanges do not lie about their income levels to get higher subsidies for insurance. People who make less than 400% of the federal poverty level, about $94,000 for a family of four, may be eligible for subsidies to pay for insurance.

• An HHS inspector general's review of the law's safeguards for reporting fraud.

Republicans had asked HHS to verify incomes as people enrolled, but most don't know how much they will make in the coming year and their incomes may differ substantially from the previous year.

Also, trying to add another system to verify incomes could slow down the already-slow health exchange sign-up process even more.

Discrepancies in claimed income compared to actual income will be clear when people file their tax returns.

The delay until 2015 of the requirement for employers with more 50 employees to provide insurance means that employers won't be verifying incomes, Holtz-Eakin said. "Given the quality of the computer system they're working with for the exchanges" immediate verification seems unlikely, Holtz-Eakin said.

Paul Ginsburg, president of the Center for Studying Health System Change, agreed that verification could be near impossible.

Holtz-Eakin said the agreement is symbolic because it plays to Republicans' stated frustration that administration officials are not playing by the rules. Earlier this year, HHS officials said they would audit a sample of people who buy insurance through the exchanges, rather than everyone.

"This is the Republicans saying, 'Pay attention to the laws that we passed,'" he said. "Don't do whatever you want."